Informatione del pestifero et contagioso morbo (review)

Giovan Filippo Ingrassia was protomedico of Palermo in 1575, when an epidemic flared out of his control. Then sixty-four years of age, Ingrassia was exceptionally well-informed about all the century's debates concerning the nature of pestilence, contagion, and epidemics. Given his official capacity, Ingrassia's initial task was to explain to the duke, a grateful former patient, and ultimately to explain to King Philip II of Spain, why physicians were unable to determine the nature and causes of the epidemic early in its course, or subsequently to arrest its progress. Ingrassia had been a guiding force importing Paduan medical humanism and anatomical reforms to Sicilian medical education, and to some extent all this was at stake for him. He claimed that the disease appeared among the lowest stratum of the population, whom neither he nor his colleagues were accustomed to treat. But what began as isolated cases in late May had caused 300 deaths by the end of June. At this point, Ingrassia went to extraordinary lengths to explain that the disease was instead a "pestiferous contagion" rather than "true plague," and he traced the first crucial transmissions to a prostitute. Contagion, however, could only be rationally explained by discussion and consideration of the places, substances, and mechanisms that led to a contact-borne disease. Given authority and sufficient resources until the end of August, Ingrassia crafted detailed instructions and guidelines for every conceivable aspect of managing a plague that could be transmitted by touch from one person or place to another. He wrote briefs and instructions explaining both the rationale and the procedures, increasingly deepening his commitment to a Fracastorian, atomistic explanation of contagion, despite his disinclination to privilege the recentiores over traditional medical authority.

When the pestiferous illness did not respond to Palermo's first experiments with a lazaretto, Ingrassia extended isolation protocols to those who recovered, those who were in some contact with the ill, and those who survived but were still deemed capable of transmitting plague. Costs mounted. The criminal-justice arm of early modern plague control took over, leaving Ingrassia to view the spread of plague through the lens of minute infractions of his complex regulations. Meanwhile, the actions of the duke's deputies determined the course of events for most poorer people. The worst of the epidemic unfolded from late August to early October, when Ingrassia was no longer directing everything. Not until the summer of 1576 did Ingrassia finish his Informatione del pestifero et contagioso morbo, a hefty, scholarly tome that includes all of his correspondence and arguments about the evidence borne out in this epidemic. Today we know, as editor Luigi Ingaliso points out, that even though Palermo accounted for over half the deaths in all Sicily during this epidemic — around 3,100 — the death rate, at 3.8 percent, was substantially less than any other locality, urban or rural.

Many historians of plague have made occasional reference to Ingrassia's extraordinary testimonial. Ingaliso's extensive introduction draws primary attention to his mentor Corrado Dollo's interest in Ingrassia's intellectual position between medieval and Renaissance medical theory and the coming Scientific Revolution, particularly in the work of Giovanni Borrelli. Dollo argued that Ingrassia's focus on material substances and conditions, with occasional references to experiments and observations, formed an important bridge within a fundamental epistemological shift within medical science, releasing methodology from philosophy. To a significant extent Ingrassia was still a man of the old world, committed to medical humanism, with its devotion to philological reflection on "pure" ancient texts, to medical astrology and the possibility of occult causes, and to a late scholastic approach to the generation of new knowledge.

Ingaliso's extensive introduction also offers a cogent summary of the course of the plague under Ingrassia's management, the intellectual position Ingrassia occupies within the larger history of the Scientific Revolution of seventeenth-century Italy, and the large number of other...